CEP 817 Problem of Practice – Define Mode (Part 1)

Challenge Related to My Initial Problem of Practice Statement : (https://paulmaz41.wordpress.com/2015/01/28/problem-of-practice/)

The challenge that I currently face is that while I have written core objectives, I am unsure what the modules will look like, how to write curriculum and how to implement the program in a manner that will prepare these novice nurses for practice.

  • “5 WHY’s” — Root Cause Analysis
      1. Why am I unsure how to write this new curriculum?
        1. Because I have never written a curriculum before
      2. Why have I never written a curriculum before?
        1. Because until now, I have not had the need to write a curriculum
      3. Why has there not been a need to write a curriculum?
        1. Because we have never had a formal training plan
      4. Why have we never had a formal training plan?
        1. Because training needs are far more complex
      5. Why are training needs far more complex?
        1. Because we are transporting sicker patients and the demands for this job have changed
  • Why – How Ladder

cep_817_pop_why_how_ladder CLICK IMAGE FOR LARGER VIEW

  • POV Madlib: [USER] needs to [USER’s NEED] because [SURPRISING INSIGHT]
    1. The pensive Survival Flight Nurse Intern needs to create engagement for his / her own learning by creating his / her own curriculum.
    2. The Survival Flight Nurse Intern needs to learn within a structured environment because this will ensure that core objectives are covered.
    3. The Survival Flight Nurse Intern, who has yet to be challenged to the degree that is required of regular Survival Flight staff, needs to experience a challenging training program, because the clinical requirements and demands are greater than they have been in previous years.

CEP 810 Final Thoughts

What I learned during CEP 810 was rather narrow with broad potential. I learned how to use Twitter. I learned what an RSS Feed is. I learned how to create a Sniglet, a Popplet, a blog and a peanut butter and jelly sandwich using a spatula. I learned the basics of XCode and how to post to YouTube. I had fun and learned about pieces of technology that I never knew existed or needed to exist. I also learned how to learn. 

I entered the MAET program not knowing how to use technology in learning, only that I wanted to introduce technology into my curriculum. I now realize that the use of technology is secondary to “why” to use and “how” to use it. I know that technology can serve a primary purpose, or be repurposed for something innovative. I am beginning to learn that I do have creative potential and that quality education requires separating myself from traditional norms. I learned that technology has a much broader definition.

There are still questions that loom for me. How do I stay on the cutting edge? Can I keep up with my newly formed network? In what ways can I repurpose the technology that I am learning, arguably geared to the K-12 crowd, for medical education? How can I learn innovation while at the same time teach my students this skill? I learned somewhere that quality learning creates more questions than answers. CEP 810 is one of the first classes in this curriculum that has done that for me. What still makes me nervous is catching up and keeping up.

But for now, I have much to integrate into my own practice. I have a solid 21st century lesson plan that I can use for a multitude of modules. I can use it as a teaching tool and evaluation tool. I have a new set of skills that will allow me to learn and implement instruction in ways that will benefit my group. Most importantly, I have a spark that will help me move forward in my primary mission: to create innovative and engaging methods of instruction in which to evolve the next generation of flight nurses. I want to make them better than I could have ever been. I feel like I am finally learning what this means and how to move forward.

Respectfully,

SF Logo

Paul M Mazurek, RN, BSN, CCRN, CFRN, NREMT-P, I/C

Educational Nurse Coordinator

University of Michigan Survival Flight

 

MAET Degree Program Candidate

Michigan State University

What I Learned from “Cooking with TPACK” (and the versatility of my “IronMan Spatula”)

In this quickfire activity, I was tasked with creating something in the kitchen from tools that I may, or may not normally use (the tools were selected prior to the task) for the job at hand. I immediately figured out how to adapt the tools for the job (referred to in our lesson as “repurposing”). As I write this post, what immediately comes to me is that in education, there is an almost limitless set of tools in which to help teach, reinforce or provide perspective. While these pre-existing tools may have a specific purpose, it is the task of the educator to utilize these tools with unique objectives in mind for his / her teachings. Just as I had to make a peanut butter and jelly sandwich with an “IronMan Spatula,” tools, apps, websites and other educational advances are “repurposed” in innovative ways that will help the student not only learn the material, but perhaps discover creativity and innovation on their own.

As Kereluik, Mishra and Koehler (2011) state “teaching must continually shift and evolve based on the contexts within which it is applied; and teachers practice in a highly complex, dynamic environment,” I learned in this brief exercise that evolving and adapting are two skills that I must possess as an educator in order to not only be at the cutting edge of my own practice, but continue to be relevant for those that I educate. If I am not able to display these characteristics in a thoughtful manner, how can I teach my students to be creative, innovative learners? With the mindset of repurposing, I now feel that I have an idea for a marketable tool that will allow PB&J’s to be created without the grotesque act of mixing the “PB” with the “J.” This is something I would not have been able to do without the inspiration of “TPACK!”

Kereluik, K., Mishra, P., & Koehler, M. (2011). On Learning to Subvert Signs: Literacy, Technology and the TPACK Framework. The California Reader, 44(2), 12-18.

Final Blog Post to My CEP 810 Networked Learning Project (NLP)

My objective over the last 4 weeks was to build an iOS App. As I have zero programming experience, I was unsure of the magnitude of this project. This however is something that I have always wanted to create for my job. While the use of this type of technology is not necessarily new to healthcare, I wanted to tailor it to my practice as a flight nurse with the hope of making good flight nurses better.

While a pretty lofty goal considering my lack of computer experience, I thought I could learn some basics over the course of 4 weeks. That was something that I was able to do. However, it wasn’t without multiple roadblocks. In order to make an iOS app, you need to have the programming language software. For iOS apps, this programming language is called XCode. This part was easy enough to get as it is a free download. XCode only runs on Mac Products which while seemingly intuitive, became a big problem for me as my 6 year old MacBook decided to crash a few times during my learning. In addition to the basics of a new programming language, I learned that I had patience!

My primary source that I used to learn this new skill was the YouTube Channel “Code with Chris.” While I tried other sites like lynda.com and the Apple Developer’s network, I obtained the most knowledge with the YouTube Channel. During the 15 video lesson, I went from basic nomenclature all the way through learning how to write various strings of code, what it meant, and how to tie the programming language with what you see on the iPhone or iPad screen. The final “product” so to speak is the card game “war.” While seemingly simplistic, from a computer programming language perspective, it has just the right degree of complexity for beginners. I had to create an image asset file, place the images on my game board, give button commands and randomize cards.

While I feel that I have learned a great deal, I also realize that I have not even scratched the surface of what is required in order to build the apps that we are all accustomed to in the Android or iOS App stores. Having said that, I feel that I am well on my way. This approach to learning is very good for me as I can do it at my own pace, I can rewind and repeat lessons and being able to follow along with a seasoned expert is invaluable. It has given me the confidence for deeper self-discovery and I anticipate that I will be well on my way to a basic level of proficiency with this program language within the next year. Because of the “Code with Chris” YouTube Channel, I have found additional and equally valuable resources that I will be able to use in order to practice and hone my skills. All that I needed was a start and this project and the new network that I have created for myself will be the driving force for continued proficiency.

The link to my YouTube Video can be found here: Mazurek Network Learning Project

CEP 817: Empathy in my Curriculum Design

As described in my initial problem of practice statement, I have been given permission and funding to start an internship program for prospective flight nurses. The first of its kind in the country, it is intended to prepare the competent ICU / Emergency Nurse to become a competent, practicing flight nurse. The program lasts one year and will consist of 10 core learning modules, critical care transport time and procedural labs. The challenge that I currently face is that while I have written core objectives, I am unsure what the modules will look like, how to write curriculum and how to implement the program in a manner that will prepare these novice nurses for practice.

As I prepare to write curriculum, I was interested to learn from our 2 newest flight nurses, Gina and Sandy. As they have recently completed their Survival Flight orientation, I feel that they possess a unique perspective in which to help me write “intern-centered” training. Last week before our staff meeting, I spent an hour talking with them over coffee. I tried to make this as “least formal” as possible in order to get real answers and emotions. My goal was to understand their unique perspectives, where they came from, what succeeded during their orientation and more importantly, what were the challenges that they experienced.

As natural as I tried to make this discussion, I still needed to take notes. I wrote down “key words and phrases” that I heard, interesting gestures and expressions that I noticed, and emotions or feelings that I interpreted as a result of the conversation. From the notes that I took, I created an Empathy Map (below) in order to visually represent what I was hearing and create common threads that would later allow me to thoughtfully insert these feelings and emotions into a worthwhile curriculum. From what I collected, I feel that Sandy and Gina’s comments are quite representative of what these interns may experience. I will use the data as a quality check while writing curriculum.

cep_817_empathy_map

EMPATHY MAP CREATED FOLLOWING MY DISCUSSION (Click for Larger Image)

What I learned from this is that my current training regimen is quite effective. What led me to this assumption was what they said and what they did during the discussion. As they smiled and joked about their experience, I sensed a feeling of comfort in answering my questions and inquiries. They were able to compare compelling stories of transports that they had been on (both good and bad but always educational). In healthcare, we often refer to these as “war stories.” They both described how positive their experiences were as they were spending time in other Intensive Care Units (ICU). The amount of simulation that they were exposed to and that they spent more time “doing” rather than learning via “Death by Powerpoint” indicated to me that they felt a sense of accomplishment in completing initial Survival Flight training which came from their ability to demonstrate rather than to merely regurgitate facts.

Likewise, some of Gina and Sandy’s comments made me realize how exhausting initial orientation can be for the novice flight nurse and that this requires a certain degree of sensitivity on my part. I have to be selective with whom I assign as trainers (preceptors) because they both in concert stated that some senior flight nurses are in engaged in the training process while others are not. While blended learning seems to be the best recipe for success based on the comments surrounding “less classroom, more hands on experience,” I also understand that as specific concepts, skills and management strategies become more complex, I will need to provide more structure, perhaps in the form of brief lectures or in-services (until now, I had approached orientation with maybe too much structure or standardization).

I feel that I am off to a very good start with respect to creating “intern-centered” training. While attempting to place myself in the shoes of trainees can be difficult, it is certainly worthwhile,  and something that I plan on doing more often and throughout the entire internship training curricula. Something that I feel that I have learned from this exercise is that these somewhat “informal” meetings can be invaluable. My plan is to make adjustments between each module based upon what I learn during intern meetings throughout the course of training and instruction.

21st Century Lesson Plan

Attached is my CEP 810 21st Century Lesson Plan for review and feedback. 

As I am not completely proficient in the art and skill  of lesson plan development, this assignment was a bit daunting at first. However, as I begin a new internship program for prospective flight nurses, this is a skill that I have discovered requires significant thought and an innovative mindset. One of the primary goals in the “creation” of a new flight nurse is that they need to possess the ability to problem solve and make decisions typically reserved for physicians. This has been something historically taught in the classroom. Since the classroom is not where these individuals will be practicing, I wish to create a lesson that will better serve their needs as well as accomplish my goal for them which is self-directed, independent thought and decision making.

During this lesson, each intern will be paired with a senior flight nurse and will participate in 2 similar yet different patient care scenarios in the cabin of the aircraft utilizing a human patient simulator. Between scenarios, they will evaluate a video recording of their performance and be given the chance to create a care standard based upon current evidence and their own understanding of how to solve this particular clinical dilemma. The intern will visually display his / her thought process and problem solving strategy in the form of an algorithm, created using the web-based software Gliffy. Learning through reflection and self-discovery is designed to occur when the intern is allowed to implement what he / she has created in the setting of the second videotaped patient care scenario.

This lesson utilizes the latest in human patient simulation technology as the primary tool for evaluation, full access to the Taubman Medical Library’s digital media and a web-based flowchart creation program in order to allow the participants to visually create their thoughts. The blended learning associated with this lesson will allow for self discovery and problem solving beyond what we can “teach” through lecture. It allows for personal reflection of their own performance, the thoughtful integration of technology that they will be utilizing during practice as a flight nurse, problem solving and decision making in a safe environment, and collaboration with proficient flight nurses and medical staff at UMHS.

To reference the message articulated by Thomas and Brown (2011), I feel that this lesson plan and subsequent instruction will not merely teach something, but will modify future behavior and assimilate the intern into the Survival Flight culture. They will become self directed, understand that learning is constant and have confidence in their abilities to seek out and find needed information. They will learn by making mistakes and they will learn in an engaging and hopefully fun environment, allowing play in an environment where play is typically not allowed.

 

Reference:

Thomas, D., & Brown, J. S. (2011). A new culture of learning: Cultivating the imagination for a world of constant change. Lexington, Ky: CreateSpace?.

NLP Week 4

Week 4 progress has not been as expected. What I have realized is that XCode, the programming language for iOS App development, like any other language, takes time and practice. This piece has been rewarding as I feel like I am starting to understand it. I have an incredible amount of information in my “XCode Notebook.”  FullSizeRender copy 2However, from a production standpoint, it has gone quite slow. I have learned terminology and nomenclature and how to translate this to basic objects on the user interface.

 

 

 

 

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The “StoryBoard”

 

Within the next several days, these user will be able to interact with these in the form of the simple card game War.  To date, I have used the following resources:

  • The YouTube Channel “Code with Chris.” As explained in my week 2 Blog post, Code with Chris is completely dedicated to iOS App development. While he mainly teaches beginners, I have noticed some interesting dialogue when going to his discussion forums for help and advice from others with much more advanced skill in this programming language. The discussion forum has been especially helpful for me as it got me through a couple of simple, yet frustrating pieces of programming. In one instance, I was having a difficult time figuring out how to place objects on the storyboard so they stayed consistently spaced regardless of the rotation of the iOS device.

 

Screen Shot 2015-02-02 at 10.26.03 PM

 

 

Original Error Message

 

Someone in the discussion forum sent me to an incredibly helpful video (coincidentally, also written by Chris). This was a much better way to learn for me. Instead of simply getting the answer and inserting revisions in my code, I was able to watch the video and practice this until I became a bit more proficient with the autocorrect and pinning features.

Screen Shot 2015-02-02 at 10.26.47 PMScreen Shot 2015-02-02 at 10.26.20 PM

  • Lynda.com is an online, video-based learning website that can teach anything from computer programs to business and marketing tactics, to photography. While I did find several interesting videos concentrating on the XCode programming language, I found myself getting confused. Having said that, as I get more proficient in XCode, Il re-explore these videos perhaps with a different perspective.
  • XCode Support from the Apple Developer Forum: Since I would have to subscribe to this service anyway in order to publish my apps in the App Store, I decided to join and get a feel for what this service could do for me. However, as I am just a beginner, this appears to cater more to software engineers and serious developers.

After exploring these options, I am going to concentrate on the YouTube videos, blog and discussion posts from Code with Chris. This video series seems to be more intuitive for me. After I get the “basics” to the XCode language, I will revisit Lynda.com, the XCode tutorial and the Apple Developer Forum.

The greatest challenge for me has been technical issues. I have an older MacBook that is running XCode 6 at a sluggish pace.  While I have ordered a new Solid State Drive and more RAM to install, which should make my computer performance issues a bit more manageable, I am still needing to make progress on this assignment. To that end, I am attempting to work through these challenges.

FullSizeRender copy

 

Additionally, learning this programming language has not progressed as quickly as I had originally hoped. I find myself needing to pause, rewind and even review videos multiple times in order to understand key concepts. However, I feel that I am making progress. Between learning XCode and performing some basic computer hardware maintenance, I will attain my eventual goal of programming a useful app for my team.

 

VIDEO OF PROGRESS CAN BE FOUND AT: Mazurek iOS App Development Progress

A New Tool for Productivity

This week, I tried the productivity tool Evernote. It is an “all in one” productivity tool. I can create lists, write notes and compile research on one site. While there is a bit of a learning curve involved, Evernote has a helpful set of tutorials and customer support. The free version appears to serve my current purposes and the paid version has some expanded features such as more storage space, offline capabilities and more robust search capabilities at a modest price.

I am using it because I am a “list” person. The only way that I know how to “get things done” is to write a list and proceed one task at a time. Not only am I creating lists within Evernote, but I can link notes to the lists for later reference. There are also useful reminder features that I can connect to for especially important task and “to do” lists.

Another thing that I am doing with Evernote is that when I learn about a new piece of technology that I think is intriguing or may be useful in the future is to take a snapshot of the website and create a web link so I can go back and explore at a later time. This helps keep me organized as it seems like new, innovative and “really cool” technologies fly at me faster than I can keep up. I can “sift” at a much more manageable pace this way.

Some challenges that I have experienced is that the organizational layout is not naturally intuitive to me. The appearance and menu items for the website are a bit different from the iPhone as well a bit different from the iPad app. While 4 days is not quite sufficient time for me to declare a certain degree of proficiency, I am quickly learning the layout however. My only tip currently for using Evernote is to have a bit of patience and explore the tutorials. They are quite helpful and give some really good ideas and insight on how to best use this tool.

My “PLC”

This “Popplet” represents what I would consider my “Professional Learning Community” (PLC). Aside from the “usual” academic sources, I rely heavily upon those individuals who develop and write the standards for care at the University of Michigan Health System (UMHS). I call them Subject Matter Experts. Sometimes, what they know and what they do are the best sources of information as it is often ahead of ” the literature” and our expectations as a transport team is to meet and exceed theirs.

Additionally, I entered the MAET program to assist me in developing skill as an innovative educator. To this end, I rely heavily upon what I have gained at Michigan State University (it’s resources, teachers and students) to assist me in this endeavor.

I would say that the weakest portion of this popplet for me is what I obtain through social media. While I am not well versed in how it works, I am very much ready and willing to learn and tap into it as a potential resource. Mazurek_PLC PoppletCLICK ON THE JPEG IMAGE 

CEP 817 “Problem of Practice”

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For the initial segment of my CEP 817 “Problem of Practice” assignment, I am initiating a forum within my web-space in order to elicit suggestions, ideas, brainstorming and mentorship from my colleagues as I initiate the design process and attempt to tackle a major problem area that I have as Clinical Educator for Survival Flight at the University of Michigan.

The University of Michigan Survival Flight nursing staff has benefited for many years with low turnover and a staff mix of long term employees. As this group of long term employees with many years of experience reaches retirement age, we anticipate an unprecedented rate of attrition. A plan must be developed to prepare a pool of potential candidates for Survival Flight practice while addressing the limitations of qualified staff and an aging workforce.

Problem Analysis / Root Cause: 25% of current Survival Flight nursing staff plans to retire within the next 2-3 years. Over the last 2 years, Survival Flight has had a total of 3 flight nurses leave due to attrition and retirement. These three positions were approved and posted. One position was immediately filled while the other 2 positions remained unfilled for nearly 9 months. In May 2014, another flight nurse left UMHS and that posting remains unfilled due to lack of qualified applicants.

Applicants that meet Survival Flight’s rigorous requirements for interview and subsequent hire are becoming exceedingly difficult to find. In order to mitigate this, a paradigm shift must ensue so that motivated individuals will be able to meet the challenges and expectations for flight nursing at the University of Michigan.

With this in mind, a plan was developed to start an internship program. The first of its kind in the country, it will prepare the competent ICU / Emergency Nurse to become a flight nurse. The program lasts one year and will consist of 10 core learning modules, critical care transport time and procedural labs. The challenge that I currently face is that while I have written core objectives, I am unsure what the modules will look like, how to write curriculum and how to implement the program in a manner that will prepare these novice nurses for practice.

As I have never designed a curriculum such as this I will look at my goals for this program, the needs of my interns and move through the design process (Stanford Design Thinking Model) in order to create a curriculum that will assist in learner success. I will research curriculum design and network with colleagues in education (K-12, business and healthcare education) and utilize the ideas that may work best for my interns. As this curriculum will be a living and breathing entity, I will revise accordingly based upon needs of my learners and what I discovered as design flaws along the way.

I welcome any and all feedback from my peers and colleagues. I realize that while I am not a novice flight nurse, I am quite novice in the area of curriculum design. I definitely have “looking at this problem through the eyes of a child” thing down!